A. Minimally invasive surgery (MIS) involves a less invasive approach to surgery than open surgery. Surgeons create a number of small cuts instead of one large cut and place instruments through these small cuts to operate. This approach can sometimes create technical limitations for the instruments that surgeons use, such as a lack of dexterity and depth-perception.

Laparoscopy is the most common type of MIS procedure used for major surgery of the stomach, intestines, kidneys and bladder. During a laparoscopic operation, instruments are passed through the body and guided by a lighted telescope with a camera on the end that allows the surgeon to see inside the body. Depending upon the operation needed and the surgeon's preferences, procedures can be performed from the front of the body, the side or the back. The instruments are held by the surgeon, who controls their movements while watching them on a video screen.

Laparoscopy may also be performed with the assistance of a surgical robotic system. Similar to laparoscopy, robotic surgery is performed by placing instruments with a lighted telescope through small incisions in the skin. This allows the surgeon to see images of the operation on a video screen.

Each subtle movement of the surgeon's wrists, hands and fingers is precisely translated to the surgical instruments inside the patient's body. This translation helps the surgeons perform complex pediatric surgical procedures.

For certain types of surgery, the robot can give the surgeon more precise control and the ability to see what they would not be able to see with a laparoscope.

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Q. Why would someone choose robotic surgery over open surgery?

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A. With robotic surgery specially trained surgeons perform complex operations through very small openings, which can:

reduce pain

shorten recovery times and hospital stays

reduce scars

Also, by using a high-tech robot, many surgeons feel they can better visualize the procedure, which can lead to greater safety and fewer issues and complications.

Keep in mind, however, that robotic surgery is only performed on certain conditions and that not all patients with those conditions are candidates for robotic surgery. Consult with your physician.

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Q. Does the robot perform the surgery by itself?

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A. No. The robotic technology we use is controlled by the surgeon at all times. You can think of the robot as an extension of the surgeon's hands. During robotically assisted surgery, the surgeon sits at a console in the operating room, and another surgeon is at your child's bedside. The robotic technology gives the child the benefits of a minimally invasive procedure because it allows the surgeon to perform complex procedures through tiny incisions with improved dexterity, precision, and visibility.

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Q. How safe is robot-assisted surgery?

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A. At Boston Children's, robotic surgery is only performed for procedures where it has been studied extensively and proven to be both effective and more beneficial than traditional open surgery. With robotic procedures, surgeons have better “visualization” than they do with open surgery because they are actually repairing organs on the inside of the body. In addition, there is less suturing with robotic surgery, which eases pain, reduces recovery times and leads to fewer complications.

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Q. What happens if there is a power outage?

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A. Our staff is trained to handle any emergency situation that may arise. If a power outage should occur, we have a back-up generator on hand to complete the procedure. Should the robot itself fail, we can revert to conventional microscopic surgery.

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Q. Is robotic surgery covered by insurance?

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A. Because every family has a unique insurance plan, it is important to speak to your doctor or call your insurance company.

Boston Children’s is so much more than a hospital—it’s a community of researchers, clinicians, administrators, support staff, innovators, teachers, patients and families, all working together to make the impossible possible.
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